• Title/Summary/Keyword: Medical-surgical nursing

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Differences in the Characteristics of Hospital Stress between Medical and- Surgical Patients. (내ㆍ외과계 환자의 입원스트레스 특성 비교)

  • 이소우;노유자;김태경
    • Journal of Korean Academy of Nursing
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    • v.19 no.1
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    • pp.99-107
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    • 1989
  • This study explored differences in how medical and surgical patients compare on the degree of hospital stress and their subjective physical status. Subjects were 343 medical and surgical patients in five university hospitals in Seoul and Taegu. They responded to the Hospital Stress Rating Scale and a self-report on physical status. The controlled variables were age, education, number of previous hospitalizations and seriousness of the illness. Medical and surgical patient differences on nine factors of the hospital stres scale and nine areas of physical conditions were reported as follows edplored : 1. 1) There was not a statistically significant difference at the .05 level in the total mean score for hospital stress between medical patients and surgical patients. 2) The mean score of the factor lack of information (M=2.308) for medical patients was higher than the mean score (M=2.064) of the surgical patients. 3) The mean scores of the factor of discomfort (M=2.130), loss of independence (M=1.889) for surgical patients were higher than for medical patients. 2. 1) There was a statistically significant difference at the .05 level in the total mean score for physical status between medical patients and surgical patients. 2) The mean scores were lower in subjective physical status for surgical patients(S) than for medical patients (M) ; stomach condition (S : M=2.8433, M : M=3.0-000), self-assistance(S : M=3.0373, M : M=3.4498), movement (S : M=2.6716, M : M=3.2392), interest in your surroundings (S : M=3.0522, M : M=3.2632). 3. Patients scoring high on the subjective physical status such as sleep, appetite, stomach condition bowel condition and urination states had higher scores in hospital stress than with patients scoring low on those subjective Physical status. The results suggest that subjective physical status might be on expression of hospital stress. Also patients with high scores in subjective physical statas might be predicted have a high level of stress on admission. And surgical patients had a higher level of hospital stress than medical patients.

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Financial Distress and its Predicting Factors among Iranian Cancer Patients

  • Fathollahzade, Abazar;Rahmani, Azad;Dadashzadeh, Abbas;Gahramanian, Akram;Esfahani, Ali;Javanganji, Leila;Nabiolahi, Leila
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1621-1625
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    • 2015
  • Background: Financial distress due to the cost of cancer treatments is prevalent among cancer patients. Identifying the level of financial distress and its affecting factors has an important role in providing supportive services. Accordingly, the aims of this study were to determine these parameters among Iranian cancer patients. Materials and Methods: This descriptive-correlational study was undertaken among 262 cancer patients admitted to both private and public hospitals in East Azerbaijan province, Iran. The financial distress/financial well being scale was used to determine financial distress. The data were analyzed using SPSS software using descriptive and inferential statistics (multiple linear regression). Results: Among the 262 cancer patients, 57.3% were male and their mean age was 47.0 years. The mean score for financial distress was 4.12 (2.01). The final regression model demonstrated that the independent variables (predictors) of income less than living expenses, income equal to living expenses, having an employed spouse in governmental job and living with parents, with regression coefficients of -1.029, -0.515, 0.198, and 0.096, respectively, were predictors of financial distress among cancer patients. These variables accounted for 50% of changes in variance of financial distress. Conclusions: Iranian cancer patients have moderate to high levels of financial distress. Considering policies for managing direct and indirect costs of cancer treatments must be followed.

Social Support and its Predictors Among Iranian Cancer Survivors

  • Faghani, Safieh;Rahmani, Azad;Parizad, Naser;Mohajjel-Aghdam, Ali-Reza;Hassankhani, Hadi;Mohammadpoorasl, Asghar
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9767-9771
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    • 2014
  • Background: Social support is an important factor in psycho-social well-being of cancer survivors. There is little information about level of social support and its predictors among cancer survivors in Iran or other Middle Eastern countries. The aims of present study were to determine the social support and its prediction factors among Iranian cancer survivors. Materials and Methods: In this descriptive-correlational study 187 cancer patients in one educational center and one private oncology office in northwest of Iran participated using a convenient sampling method. The data collection tool consisted of a researcher-prepared checklist and the Multidimensional Scale of Perceived Social Support Assessment (MSPSS). Data analysis was performed using SPSS statistical software with descriptive statistics and multiple linear regression analysis. Results: The total score of MSPSS was 68 from a possible score between 7 and 84. Participants believed that they received a high level of support from their family members and significant others. Multiple linear regression analysis showed that single and depressed cancer survivors and participants with lower levels of physical activity believed that they received lower levels of social support. Conclusions: Iranian cancer survivors receive high levels of social support and family members are the most important source of this support. In planning any supportive care program for Iranian cancer survivors this strength should be considered. Especially, single and depressed and patients with lower levels of physical activity need more attention.

Effects of Early Oral Feeding versus Delayed Oral Feeding on Bowel Function, Gastrointestinal Complications and Surgical Recovery after Cesarean Section under Regional Anesthesia: Systematic Review and Meta-Analysis (부위마취로 제왕절개 수술을 받은 산모의 조기 경구섭취가 장 기능, 위장관 합병증 및 수술 후 회복에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, HyoJin;Jeon, YeongKyung;Yoon, SoYoung;Lee, GeumMoon
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.732-745
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    • 2021
  • Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

Determination of Nursing Costs for Hospitalized Patients Based on the Patient Classification System (종합병원에 입원한 환자의 간호원가 산정에 관한 연구)

  • 박정호;송미숙
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.16-37
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    • 1990
  • A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

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Critical Care Nurses' Perception, Knowledge, and Practices of Enteral Nutrition (중환자간호사의 경관영양 공급에 대한 인식과 지식 및 수행)

  • Kim, Hyunjung;Soun, Eunjin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.4
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    • pp.383-392
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    • 2016
  • Purpose: The purpose of this study was to assess critical care nurses' perception, knowledge, and nursing practices regarding enteral nutrition. Methods: A descriptive study was conducted with 187 nurse participants who worked in one of the eight medical and surgical intensive care units (ICUs) from four hospitals in Korea. Data were collected using a self-administered questionnaire. Results: Although critical care nurses' perception toward enteral nutrition was high, knowledge was relatively low. The overall perception and knowledge of the nurses did not differ significantly between medical ICU and surgical ICU nurses. Perception of their own knowledge, in particular, 'nutritional goal' was lower for medical ICU nurses compared to surgical ICU nurses. Nurses also had limited knowledge about the significance of enteral nutrition, confirmation of feeding tube location, and nutritional requirements for ICU patients. They inadequately performed the following: changing the feeding tube every 24 hours, inspecting nostrils daily, and adjusting feeding schedule if feeding was stopped. Conclusion: Our results indicate that ICU nurses need up-to-date information about enteral nutrition. Based on the improved perception and knowledge, nursing practice activities with regard to enteral nutrition should be emphasized to enable nurses to provide optimal nutrition for ICU patients.

Factors Influencing on Quality of Sleep among Patients at Surgical Intensive Care Units (외과계 중환자의 수면질에 영향을 미치는 요인)

  • Kim, Hye-Soon;Lee, Myung-Hee;Kim, See-Young
    • Korean Journal of Adult Nursing
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    • v.20 no.3
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    • pp.365-374
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    • 2008
  • Purpose: This study was conducted to evaluate quality of sleep and to assess the factors that influence quality of sleep in surgical ICU. Methods: The subject of the study were consisted 109 adult patients who admitted to surgical ICU. The data were collected from May 20 to December 10, 2007 by structured questionnaires. The data were analyzed with descriptive analysis, paired t-test, Pearson correlation coefficient and stepwise multiple regression. Results: The score of quality of sleep was 4.57 point. The main sleep disturbance factors related to quality of sleep in surgical ICU inpatient were sleep time, machinery alarm and noise(adjusted $R^2$=33.2). Conclusion: Based on the finding of this study, it is needed to develop a nursing intervention program that including to promote quality of sleep and to decrease machinery alarm and noise in surgical ICU.

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Experience of Patients and Families about Flexible Visiting (중환자실 환자와 가족의 자율면회 경험)

  • Dan, So-Young;Park, Sook-Hyun;Lee, Seul;Park, Hye-Yeon;Yi, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.51-62
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    • 2017
  • Purpose: This study aimed to understand the essence of experiences of patients and family members during flexible visiting in an intensive care unit (ICU). Methods: This is a qualitative study using interviews with open ended questions. We used Colaizzi's method of phenomenological interpretation. Results: Flexible visiting in the ICU impacted the patients and their families in various ways. The following categories were extracted from the patients' experiences with flexible visiting: 1) the opportunity to feel the presence of the family and 2) the burden of unrestricted visiting. The following categories were extracted from the families' experiences with flexible visiting: 1) psychological comfort by convenience 2) being aware of health care professionals and critical care nursing in the intensive care unit, and 3) double trouble. Conclusions: These results showed that flexible visiting in the ICU affected the patients and their families positively and negatively. Therefore, nursing staff need to design psychological and social interventions that address the needs of patients and their families.

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Cancer Care Burden among Primary Family Caregivers of Iranian Hematologic Cancer Patients

  • Abbasnezhad, Masoomeh;Rahmani, Azad;Ghahramanian, Akram;Roshangar, Fariborz;Eivazi, Jamal;Azadi, Arman;Berahmany, Golshan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5499-5505
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    • 2015
  • Background: Providing care for hematologic cancer patients may lead to many negative complications in different aspects of life in their family caregivers. Based on a wide review of relevant literature, there are limited data about the burden of giving care for hematologic cancer patients on their primary family caregivers in Iran or other Middle Eastern countries. Therefore, the aim of this study was to investigate the cancer care burden on primary family caregivers of hematologic cancer patients, in terms of physical, psychological, social, spiritual, and financial aspects. Materials and Methods: In this descriptive study, 151 primary family caregivers of hematologic cancer patients referred to two cancer care centers in East Azerbaijan Province in northwest of Iran participated. The Financial Distress/Financial Well-being Scale, Hospital Anxiety and Depression Scale, Vaux Social Support Questionnaire, Spiritual Well-being Scale, and SF-36 were used for data collection. Data analysis was performed with SPSS software. Results: The findings of this study indicated that the primary family caregivers experience a high level of financial distress and a significant percentage of them suffered from anxiety and depression. In addition, the physical quality of life in these caregivers was moderate. On the other hand, spiritual health and social support of participants was at an acceptable level. Conclusions: Iranian primary family caregivers of hematologic cancer patients experience many problems in physical, psychological, and financial aspects of their life. Therefore, developing care plans for reducing these problems appears necessary.

Risk Factors of Delirium Among the Patients at a Surgical Intensive Care Unit (일 종합병원 외과계 중환자실 환자의 섬망 발생 요인)

  • Chun, You Kyoung;Park, Jeong Yun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.31-40
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    • 2017
  • Purpose : This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU). Methods : This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records. Results : Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters. Conclusion : The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.

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